Uses of Topamax:

• It is used to treat seizures.
• It is used to prevent migraine headaches.
• It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take Topamax?

• If you have an allergy to topiramate or any other part of Topamax (topiramate tablets).
• If you are allergic to Topamax (topiramate tablets); any part of Topamax (topiramate tablets); or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.

This medicine may interact with other drugs or health problems.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Topamax (topiramate tablets) with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Topamax?

• Tell all of your health care providers that you take Topamax (topiramate tablets). This includes your doctors, nurses, pharmacists, and dentists.
• Avoid driving and doing other tasks or actions that call for you to be alert until you see how Topamax (topiramate tablets) affects you.
• Talk with your doctor before you use other drugs and natural products that slow your actions.
• Sweating less and high body temperatures have happened with Topamax (topiramate tablets). Sometimes, this has led to the need for treatment in a hospital. Be careful in hot weather and while being active. Call your doctor right away if you have a fever or you do not sweat during activities or in warm temperatures.
• Patients who take Topamax (topiramate tablets) may be at a greater risk of having thoughts or actions of suicide. The risk may be greater in people who have had these thoughts or actions in the past. Call the doctor right away if signs like low mood (depression), nervousness, restlessness, grouchiness, panic attacks, or changes in mood or actions are new or worse. Call the doctor right away if any thoughts or actions of suicide occur.
• This medicine may cause an acid blood problem (metabolic acidosis). The chance may be higher in children and in people with kidney problems, breathing problems, or diarrhea. The chance may also be higher if you take certain other drugs, if you have surgery, or if you are on a ketogenic diet. Over time, metabolic acidosis can cause kidney stones, bone problems, or growth problems in children.
• This medicine may raise the chance of bleeding. Sometimes, bleeding can be life-threatening. Talk with the doctor.
• This medicine may cause very bad eye problems. If left untreated, this can lead to lasting eyesight loss. Call your doctor right away if you have new eye signs like blurred eyesight or other changes in eyesight, eye pain, or eye redness.
• Taking Topamax (topiramate tablets) with valproic acid can cause low body temperature. This can also cause tiredness, confusion, or coma. Talk with the doctor.
• Use with care in children. Talk with the doctor.
• This medicine may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.
• Birth control pills and other hormone-based birth control may not work as well to prevent pregnancy. Use some other kind of birth control also like a condom when taking Topamax (topiramate tablets).
• If you are taking hormone-based birth control and you have any change in your bleeding pattern, talk with your doctor.
• This medicine may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking Topamax (topiramate tablets), call your doctor right away.
• If you are able to get pregnant but do not want to get pregnant, use birth control that you can trust to prevent pregnancy while taking Topamax (topiramate tablets).
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

How is this medicine (Topamax) best taken?

Use Topamax (topiramate tablets) as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take with or without food.
• Keep taking Topamax (topiramate tablets) as you have been told by your doctor or other health care provider, even if you feel well.
• Do not stop taking Topamax (topiramate tablets) all of a sudden without calling your doctor. You may have a greater risk of seizures. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
• Drink lots of noncaffeine liquids unless told to drink less liquid by your doctor.
• Have blood work checked as you have been told by the doctor. Talk with the doctor.
• Swallow whole. Do not chew, break, or crush.
• Avoid drinking alcohol while taking Topamax (topiramate tablets).

What do I do if I miss a dose?

• Take a missed dose as soon as you think about it.
• If it is less than 6 hours until the next dose, skip the missed dose and go back to the normal time.
• Do not take 2 doses at the same time or extra doses.
• If you miss 2 doses, call your doctor.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of too much acid in the blood (acidosis) like confusion; fast breathing; fast heartbeat; a heartbeat that does not feel normal; very bad stomach pain, upset stomach, or throwing up; feeling very sleepy; shortness of breath; or feeling very tired or weak.
• Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
• Signs of high ammonia levels like a heartbeat that does not feel normal, breathing that is not normal, feeling confused, pale skin, slow heartbeat, seizures, sweating, throwing up, or twitching.
• Any unexplained bruising or bleeding.
• Feeling confused, not able to focus, or change in behavior.
• Memory problems or loss.
• Trouble speaking.
• Trouble sleeping.
• Change in balance.
• Very bad dizziness or passing out.
• Not able to eat.
• Back pain, belly pain, or blood in the urine. May be signs of a kidney stone.
• A burning, numbness, or tingling feeling that is not normal.
• Bone pain.
• Chest pain.
• Muscle pain or weakness.
• Shakiness.
• Trouble walking.
• Not able to control eye movements.
• Liver problems have rarely happened with Topamax (topiramate tablets). Sometimes, this has been deadly. Call your doctor right away if you have signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.

What are some other side effects of Topamax?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Constipation, diarrhea, stomach pain, upset stomach, throwing up, or feeling less hungry.
• Change in taste.
• Weight loss.
• Feeling nervous and excitable.
• Feeling dizzy, sleepy, tired, or weak.
• Headache.
• Flushing.
• Signs of a common cold.
• Joint pain.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Topamax?

• Store at room temperature.
• Keep lid tightly closed.
• Protect from light.
• Store in a dry place. Do not store in a bathroom.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Consumer Information Use and Disclaimer

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else's drugs.
• This medicine comes with an extra patient fact sheet called a Medication Guide. Read it with care. Read it again each time Topamax (topiramate tablets) is refilled. If you have any questions about Topamax (topiramate tablets), please talk with the doctor, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Frequently asked questions

• Does this drug cause weight loss?
• Can you stop taking this drug suddenly?
• When's the best time of day to take it?
• Can antidepressants be used for arthritis pain?
• Is this a controlled substance?
• What not to take with topiramate?
• Does topiramate cause hair loss?

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